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Introduction

Bharti AXA Smart Health Critical illness plan offers coverage to an individual after first diagnosis of critical illness. Under this plan there are two Sections- Section I provides reimbursement benefit or medical expense cover (like in case of any Mediclaim policy) up to sum insured after diagnosis while Section II provides lump sum payment up to sum insured (irrespective of hospitalization expenses) after first diagnosis. The individual opting this policy has an option to choose benefit under either Section I or Section II

Note: Under this plan, in case of multiple diagnosis the benefit can be availed only once. Also, in case of a family floater, once the claim is made by any one of the family members the plan cannot be further renewed for other members on floater basis.

Main Highlight of the plan

The benefits offered under Bharti AXA Smart Health Critical illness plan are:

  • 1. It gives an individual option to choose reimbursement (under Section I) or lump sum benefit (under Section II) as critical illness benefit.
  • 2. It has an option to opt for individual or family floater cover.
  • 3. Discount of 5% on the premium is provided up to a maximum of 25% is provided after every claim free year.
  • 4. 20 critical illnesses are covered under this plan.

Scope of cover

  • 1. The individual between age 3 months up to 55 years can be covered in the plan.
  • 2. The plan is available for proposer, lawful spouse and a maximum of two dependent children up to age 23 years.
  • 3. Sum insured– There are three sum insured options of INR 2,00,000; INR 3,00,000 and INR 5,00,000 available in this plan.

NUMBER OF AILMENTS – The Bharti AXA Smart Health Critical illness policy offers coverage for 20 critical illnesses.

LIST OF CRITICAL ILLNESSES COVERED* –

  • 1. Cancer of specified severity
  • 2. First heart attack
  • 3. Coronary artery disease
  • 4. Open chest Coronary Artery Bypass Graft (CABG)
  • 5. Open Heart Replacement of Heart Valves
  • 6. Surgery to Aorta
  • 7. Stroke resulting in permanent symptoms
  • 8. Kidney failure which requires regular dialysis
  • 9. Aplastic Anemia
  • 10. End stage Lung disease
  • 11. End stage Liver failure
  • 12. Coma of specified severity
  • 13. Major burns
  • 14. Major organ/ bone marrow transplant
  • 15. Multiple sclerosis with recurring symptoms
  • 16. Fulminant hepatitis
  • 17. Motor neurone disease exhibiting permanent symptoms
  • 18. Primary permanent hypertension
  • 19. Terminal illness
  • 20. Bacterial meningitis

All the diseases mentioned above are covered after Survival of 30 days post diagnosis of critical illness.

Coverage: Benefits & Features

Most Important

The Section I of the Bharti AXA Smart Health Critical illness policy offers following benefits in case of hospitalization:

Good to have

PRE/POST HOSPITALIZATION- For claim under Section I of this policy, the pre-hospitalization expense for a maximum of 30 days and post hospitalization for a maximum of 60 days is covered in this policy.

RESTORE BENEFITS

This plan does not offer restore benefit.

HEALTH CHECK-UP

This plan reimburses 50% of the amount spend on pre-policy health check-up.

Value Adds

All the benefits mentioned above talk about benefits applicable under Section I of the policy. For Section II the policy provides compensation amount equal to 100% of sum insured after diagnosis of critical illness and irrespective of hospitalization expenses.
*Note- For benefit under any one of the above Sections it is mandatory that the illness should fall under the critical illness category as defined by the insurance company. For more details on the categories defined please refer the policy wordings.

Exclusions

Waiting Period

Note: In case you are porting from policy A to this policy the terms and conditions under this section would differ. Please refer the policy wording or contact Coverfox for more details.

Permanent Exclusions*

Note: For detail list of exclusions, please refer the policy wording.